Provider Demographics
NPI:1366710279
Name:BYLUND, NANCY
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:BYLUND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P. O. BOX 133
Mailing Address - Street 2:
Mailing Address - City:FINLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95435-5720
Mailing Address - Country:US
Mailing Address - Phone:707-318-4560
Mailing Address - Fax:
Practice Address - Street 1:7000B SOUTH CENTER DRIVE
Practice Address - Street 2:
Practice Address - City:CLEARLAKE
Practice Address - State:CA
Practice Address - Zip Code:95422
Practice Address - Country:US
Practice Address - Phone:707-994-7090
Practice Address - Fax:707-994-7092
Is Sole Proprietor?:No
Enumeration Date:2011-12-06
Last Update Date:2012-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT26808167G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes167G00000XNursing Service ProvidersLicensed Psychiatric Technician